Do guidelines recommending pharmacogenetic testing of psychiatric patients affect treatment costs and the use of healthcare services?

Scandinavian Journal of Public Health

Volumn 39, Issue 2, 2011, Pages 147-155

  Herbild, Louise ^a   Gyrd Hansen, Dorte ^a   Bech, Mickael ^b   Christensen, Mona ^c   Werge, Thomas ^d   Nielsen, Kirsten Annette ^e  

^a UNIVERSITY OF SOUTHERN DENMARK   (Denmark)

^b ODENSE UNIVERSITY HOSPITAL   (Denmark)

^c Psychiatric Hospital of Dianalund   (Denmark)

^d Mental Health Services CPH   (Denmark)

^e DANISH EPILEPSY CENTRE   (Denmark)

Author keywords

Cytochrome P 450 enzyme system; economics; multilevel analysis; pharmacogenetics; psychiatry

Indexed keywords

CYTOCHROME P450 2D6; PSYCHOTROPIC AGENT;

ADULT; ARTICLE; COMPARATIVE STUDY; COST CONTROL; DENMARK; DRUG COST; DRUG MONITORING; ECONOMICS; ENZYMOLOGY; FEMALE; GENETICS; HEALTH CARE COST; HEALTH CARE DELIVERY; HUMAN; MALE; MENTAL DISEASE; OUTCOME ASSESSMENT; PATIENT COMPLIANCE; PERSONALIZED MEDICINE; PHARMACOGENETICS; PRACTICE GUIDELINE; REGISTER; RETROSPECTIVE STUDY;

ADULT; COST SAVINGS; CYTOCHROME P-450 CYP2D6; DELIVERY OF HEALTH CARE; DENMARK; DRUG COSTS; DRUG MONITORING; FEMALE; HEALTH CARE COSTS; HUMANS; INDIVIDUALIZED MEDICINE; MALE; MEDICATION ADHERENCE; MENTAL DISORDERS; OUTCOME ASSESSMENT (HEALTH CARE); PHARMACOGENETICS; PRACTICE GUIDELINES AS TOPIC; PSYCHOTROPIC DRUGS; REGISTRIES; RETROSPECTIVE STUDIES;

EID: 79952554023     PISSN: 14034948     EISSN: None     Source Type: Journal    
DOI: 10.1177/1403494810393300     Document Type: Article

References (31)

1. Mathers C.D., Bernard C., Moesgaard K.I., Inoue M., Fat D.M., Shibuya K., et al. Global burden of disease 2002: data sources, methods and results, 54 edn. Geneva: World Health Organization; 2003.
2. Wittchen H., Jacobi F. Size and burden of mental disorders in Europe - a critical review and appraisal of 27 studies. Eur Neuropsychopharmacol 2005; 15:357-376.
3. Gray R., Wykes T., Gournay K. From compliance to concordance: a review of the literature on interventions to enhance compliance with antipsychotic medication. J Psychiatric Mental Health Nurs 2002;9(3):277-284.
4. Rettenbacher M., Burns T., Kemmler G., Fleischhacker W.W. Schizophrenia: attitudes of patients and professional carers towards the illness and antipsychotic medication. Pharmacopsychiatry 2004;37(3):103-9.
5. Evaluation of Genomic Applications in Practice and Prevention (EGAPP) Working Group. Recommendations from the EGAPP Working Group: testing for cytochrome P450 polymorphisms in adults with nonpsychotic depression treated with selective serotonin reuptake inhibitors. Genet Med 2007;9(12):819-825.
6. Brøsen K. Klassisk Farmakogenetik [Classical pharmacogenetics]. Ugeskr Læger 2005;167(20):2143-6.
7. Andersson T., Flockhart D.A., Goldstein D.B., Huang S.M., Kroetz D.L., Milos P.M., et al. Drug-metabolizing enzymes: evidence for clinical utility of pharmacogenomic tests. Clin Pharmacol Ther 2005;78(6):559-581.
8. de Leon J., Armstrong S.C., Cozza K.L. Clinical guidelines for psychiatrists for the use of pharmacogenetic testing for CYP450 2D6 and CYP450 2C19. Psychosomatics 2006;47(1):75-85.
9. Hiratsuka M., Sasaki T., Mizugaki M. Genetic testing for pharmacogenetics and its clinical application in drug therapy. Clin Chim Acta 2006;363(1-2):177-186.
10. Ingelman-Sundberg M. Genetic polymorphisms of cytochrome P450 2D6 (CYP2D6): clinical consequences, evolutionary aspects and functional diversity. Pharmacogenomics J 2005;5(1):6-13.
11. Kirchheiner J., Bertilsson L., Bruus H., Wolff A., Roots I., Bauer M. Individualized medicine - implementation of pharmacogenetic diagnostics in antidepressant drug treatment of major depressive disorders. Pharmacopsychiatry 2003;36(Suppl 3):S235-S243.
12. Ingelman-Sundberg M. The human genome project and novel aspects of cytochrome P450 research. Toxicology Applied Pharmacol 2005;207(2, Supplement 1):52-56.
13. Matchar D.B., Thakur M.E., Grossman I., McCrory D.C., Orlando L.A., Steffens D.C., et al. Testing for cytochrome P450 polymorphisms in adults with non-psychotic depression treated with selective serotonin reuptake inhibitors (SSRIs). 146 ed. Duke Evidence-based Practice Center. Durham, NC: Agency for Healthcare Research and Quality, US Department of Health and Human Services; 2006.
14. Wedlund P.J., de Leon J. Cytochrome P. 450 2D6 and antidepressant toxicity and response: what is the evidence? Clin Pharmacol Ther 2004;75(5):373-5.
15. Bray J., Clarke C., Brennan G., Muncey T. Should we be ‘pushing meds’? The implications of pharmacogenomics. J Psychiatr Ment Health Nurs 2008;15(5):357-364.
16. Thakur M., Grossman I., McCrory D.C., Orlando L.A., Steffens D.C., Cline K.E., et al. Review of evidence for genetic testing for CYP450 polymorphisms in management of patients with nonpsychotic depression with selective serotonin reuptake inhibitors. Genet Med 2007;9(12):826-835.
17. Chou W.H., Yan F.X., de Leon J., Barnhill J., Rogers T., Cronin M., et al. Extension of a pilot study: impact from the cytochrome P450 2D6 polymorphism on outcome and costs associated with severe mental illness. J Clin Psychopharmacol 2000;20(2):246-251.
18. Bijl M.J., Visser L.E., Hofman A., Vulto A.G., van G.T., Stricker B.H., et al. Influence of the CYP2D6*4 polymorphism on dose, switching and discontinuation of antidepressants. Br J Clin Pharmacol 2008;65(4):558-564.
19. Rau T., Wohlleben G., Wuttke H., Thuerauf N., Lunkenheimer J., Lanczik M., et al. CYP2D6 genotype: impact on adverse effects and nonresponse during treatment with antidepressants - a pilot study. Clin Pharmacol Ther 2004;75(5):386-393.
20. Mulder H., Herder A., Wilmink F.W., Tamminga W.J., Belitser S.V., Egberts A.C. The impact of cytochrome P4502D6 genotype on the use and interpretation of therapeutic drug monitoring in long-stay patients treated with antidepressant and antipsychotic drugs in daily psychiatric practice. Pharmacoepidemiol Drug Saf 2006;15(2):107-114.
21. Kolonien Filadelfia. Laboratoriet i Dianalund [The laboratory at Dianalund]. http://laboratorietepilepsihospitaletdk/2007August9 (accessed 15 August 2007), available from: http://www.laboratoriet.epilepsihospitalet.dk/.
22. Rasmussen J.O., Christensen M., Svendsen J.M., Skausig O., Hansen E.L., Nielsen K.A. CYP2D6 gene test in psychiatric patients and healthy volunteers. Scand J Clin Lab Invest 2006;66(2):129-136.
23. World Health Organization. WHO International Classification of Diseases. http://www.whoint/classifications/apps/icd/icd10online (accessed 5 April 2006), available from: http://www.who.int/classifications/apps/icd/icd10online/.
24. WHO. The WHO Collaborating Centre for Drug Statistics Methodology. http://www.whoccno/atcddd/2006 (accessed 9 December 2006), available from: http://www.whocc.no/atcddd/.
25. Grieve R., Nixon R., Thompson S.G., Normand C. Using multilevel models for assessing the variability of multinational resource use and cost data. Health Econ 2005;14(2):185-196.
26. Grieve R., Nixon R., Thompson S.G., Cairns J. Multilevel models for estimating incremental net benefits in multinational studies. Health Econ 2007;16(8):815-826.
27. Grol R. Knowledge transfer in mental health care: how do we bring evidence into day-to-day practice? Can J Psychiatry 2008;53(5):275-6.
28. Grimshaw J.M., Russell I.T. Effect of clinical guidelines on medical practice: a systematic review of rigorous evaluations. Lancet 1993;342(8883):1317-1322.
29. Chen S., Chou W.H., Blouin R.A., Mao Z., Humphries L.L., Meek Q.C., et al. The cytochrome P450 2D6 (CYP2D6) enzyme polymorphism: screening costs and influence on clinical outcomes in psychiatry. Clin Pharmacol Ther 1996;60(5):522-534.
30. Herbild L., Gyrd-Hansen D., Bech M. Patient preferences for pharmacogenetic screening in depression. Int J Technol Assess Health Care 2008;24(1):96-103.
31. Herbild L., Bech M., Gyrd-Hansen D. Estimating the Danish population’s preferences for pharmacogenetic testing using a discrete choice experiment. The case of depression. Value in Health 2009;12(4):560-7.